La sexualidad humana “riqueza de toda la persona”

Para comprender plenamente el gran valor encerrado en la relación sexual-genital, debemos recordar que la relación, en la cual el hombre y la mujer se entregan recíprocamente, es también el lugar donde puede concretarse la llamada a la existencia de una nueva vida. De este modo el origen del ser humano viene a ser fruto y signo de la unión no sólo física sino también afectiva-espiritual de sus padres, los cuales deben sentir luego como derecho/deber el garantizar al hijo un crecimiento sereno en un contexto familiar estable

il protocollo di groningen

La sindrome da iperstimolazione ovarica è la complicanza più seria dell'induzione dell'ovulazione, a cui si ricorre in presenza di insufficienza dell'asse ipotalamo-ipofisi-ovaio o nei protocolli di fecondazione artificiale. Si tratta di una malattia tipicamente iatrogena, che comprende una serie di disfunzioni e varia da una forma benigna ad una condizione estremamente grave fino alla morte della donna. A fronte della difficoltà di interpretare i meccanismi eziopatogenetici responsabili e di attuare una reale prevenzione, sono stati proposti diversi accorgimenti. D'altra parte, in quanto malattia iatrogena, la sindrome da iperstimolazione ovarica pone in modo forte l'interrogativo sulla doverosità di tale prevenzione, anche se appare necessaria una riflessione molto più ampia proprio sulle giustificazioni e sui limiti della cosiddetta "medicina della riproduzione". ---------- Ovarian hyperstimulation syndrome (OHSS) is the most serious complication of the induction of ovulation during the treatment of hypothalamus-hypophysis- ovary insufficiency or under the protocols of artificial fertilization. OHSS is a tipically iatrogenic disease, which contains different dysfunctions and varies from very soft forms to extremely grave conditions and even to death of woman. The mechanisms of the aetiology and pathogenesis of OHSS is still very unclear and there are serious problems of prevention. Because of iatrogenic origin of the syndrome, the question of necessity of prevention becomes even more urgent, and occupies an important place in the very large discussion about the justifications and the limits of so called "medicine of reproduction"

Health Technology Assessment and Ethics Health

A trend or a useful tool? HTA (Health Technology Assessment) was born in the 70s as a tool to support decision makers in the health sector and has been quickly developing since, also with the creation of specialized international agencies (e.g. Health Technology Assessment International \u2013 HTAi; International Network of Assessment Agencies of health technologies - INAHTA). What is HTA? It is the \u201csystematic evaluation of the properties and effects of a health technology, which addresses the direct and expected effects of this technology, as well as its indirect and unintended consequences, and aims primarily to inform decision-makers on health technologies\u201d. The approach is interdisciplinary, because HTA summarizes information on medical, social, economic and ethical issues, and methods of evaluation can be different. Since of its born, ethics has been considered a key element in HTA, even if there is still not an agreement on \u201cwhy\u201d and \u201chow\u201d ethics should be integrated in HTA. This difficulty is not new and it mainly due to the narrowing of HTA to economic analysis. In 2004, ten Have has listed some potential reasons of this situation: a) Existing approaches for ethical inquiry are not suitable for HTA; b) Technologies are often considered by HTA producers as being value-free; c) The only questions perceived as relevant in an HTA are technical and economical ones; d) Value issues may be acknowledged to be present at all levels in HTA, but ethics is not needed to address these issues; e) It is practically difficult to integrate ethical considerations in HTA; f) HTA experts are not trained to make ethical assessments and there is too little expertise on ethics and HTA; g. Limited resources available to conduct ethical analyses

Knowledge, attitudes, and health status of childbearing age young women regarding preconception health - an Italian survey

Introduction Preconception health is a public health issue, concerning aspects that could have repercussions on pregnancy outcomes. Despite the importance, often there is a lack of knowledge, particularly among young women. The objective of this cross-sectional study is to evaluate knowledge, attitudes and health status of young women regarding preconception health in the Italian context. Methods From July 2020 until April 2021 a validated questionnaire (systematic review, Delphi procedure and pilot study) was administered to a sample of 340 women aged 18 to 25 years, attending secondary grade schools and universities. It collected information on knowledge, physical, sexual and mental health. T-test and analysis of variance (ANOVA) were used to determine a statistically significant difference in knowledge mean score (KMS) among different groups. Results KMS was 67.6% (SD=18.1). Participants with Italian nationality, enrolled in a health-field university, with a full-time job, an income higher than 35,000€/year and teachers or health providers as information source, had a significantly higher KMS. Only 15.9% of women who saw a gynaecologist in the last year (47.7%) asked about preconception health. Even if 56.5% knew that folic acid is effective in reducing the risk of neural tube defects, only 5.9% was taking it. 82.3% was living in stressing environment. Gender-based discrimination at work, school or family was felt by 25.1%, while 38.2% experienced at least one type of violence. Conclusions Promoting preconception health by improving knowledge, attitudes and behaviours may be an impactful possibility to reduce inequalities and improve women’s, children’s, and communities’ health

A Comprehensive assessment of preconception health needs and interventions regarding women in childbearing age: a systematic review

Background This systematic review summarizes the preconception health needs of women in childbearing age, necessary to be addressed to have an eventual safe and healthy pregnancy. Methods Web of Science, PubMed and Scopus were searched. We excluded studies involving women with reproductive system pathologies and referring to interconceptive or pregnancy period and non-empirical or only abstract studies. Two researchers independently performed the blind screening based on titles/abstracts and full-text and the quality assessment. Results Four major domains resulted from the thematical analysis: knowledge, behaviours and attitudes, health status and access to healthcare services. The most examined topics were knowledge and awareness on preconception health, folic acid assumption, tobacco and alcohol consumption, physical activity and healthy diet. Conclusions This review could assist healthcare professionals (physicians, nurses, midwives) in guiding tailored counselling to women to provide the adequate level of preconception care and act as a reference to policymakers

Prevalence, socio-economic predictors and health correlates of food insecurity among Italian children- findings from a cross-sectional study

AbstractConsidering food insecurity is a problem, even in developed countries, and the evidence gap regarding this issue in Italy, we aimed to assess the prevalence of food insecurity in a sample of Italian children and examine socio-economic and health correlates. This cross-sectional study was conducted in paediatric practices. Parents answered to the 18-items of the Household Food Security Module, 8 of which concern children. Paediatricians answered a questionnaire on children's health. Socio-economic and health correlates of food insecurity in children were assessed using univariable and multivariable logistic regression. Among 573 households with children, 15·4% were food insecure, while 9·1% of children were food insecure. Socio-economic factors associated to food insecurity were living in south Italy, households with three or more children, lower household yearly income, worse economic situation description and younger parents. Food insecure children were less likely to have a normal relational [ aOR 0.31 (CI 0.11-0.85)] and physical development [aOR 0.32(CI 0.15-0.65) and had more school difficulties [aOR 3.1(CI 1.33-7.24)] compared to their food secure peers. Food insecure children had higher odds of a deterioration in their health since birth and of a worse perceived health status, as reported by their parents. Considering the results in this sample and the lack of research regarding this issues in Italy and Europe more broadly, we call for consistent, national monitoring to determine the magnitude of the problem of food insecurity in households with children in Italy and to examine the socio-economic variables and health implications in different contexts